As a comparison, things could be worse.  From the sound of this story, money talks first and surviving is secondary.  BD 

When Karen Papiyants lost his leg in a road accident last year, his medical nightmare was only beginning.

Although, like any Russian, he was entitled to free treatment, he says the doctors strongly suggested he pay $4,500 into their St. Petersburg hospital's bank account, or be deprived of proper care -- and perhaps not even survive.

Faced with that choice, the 37-year-old truck driver's relatives scrambled to scrape together the money. But Papiyants said that did not stop the nursing staff from leaving him unattended for most of the night and giving him painkillers only after he screamed in agony.

In theory, Russians are supposed to receive free basic medical care. But patients and experts say doctors, nurses and surgeons routinely demand payments -- even bribes -- from those they treat. And critics say the practice persists despite the booming economy and the government's decision to spend billions to improve the health care system. 

Kirill Danishevsky, a health researcher with the Russian Academy of Sciences' Open Health Institute, has estimated that up to 35 percent of money spent on health care consists of under-the-table payments.

At the Dzhanelidze Emergencies Institute where Papiyants was treated, spokesman Vadim Stozharov denied that doctors refused to provide free care. But he conceded the hospital has received so many similar complaints it set up a hot line to deal with them.

Medical care here is among the worst in the industrialized world, experts agree.

Corrupt Doctors Plague Hospitals


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